The system for challenging decisions about social care can be confusing, lengthy, complicated and stressful, an inquiry has found.
Many people – often those who are already vulnerable – can feel ignored when trying to challenge decisions, the Equality and Human Rights Commission (EHRC) said.
The watchdog launched an investigation in July 2021 after organisations supporting older and disabled people raised concerns that they face barriers to complaining about or challenging decisions regarding their care.
It considered the procedures in place among local authorities across England and Wales as well as gathering insight from social care professionals.
Some fear that, if they challenge a decision, they may lose their care. Too many people do not seek help or feel ignored, often when they are already vulnerable— Equality and Human Rights Commission
The EHRC found that some social care users and carers are reluctant to challenge decisions because they are afraid of possible negative repercussions including losing their existing care.
Many also felt complaining was pointless due to previous experience of concerns being ignored and key points not being considered, while advocacy providers, lawyers, charities and voluntary organisations pointed out that individuals often depend on local authority staff for support and want to stay on good terms with them.
The report found issues with signposting people to advice or support that is independent of the local authority to seek information on making a complaint – with only 42% of local authorities in England and Wales saying they do this in every case.
In the findings, published on Tuesday, the EHRC said: “We found that the system for challenging decisions is confusing and subject to long delays. Local authority complaints processes are often complicated and stressful.
“People may not be given important information about how to challenge decisions. Some fear that, if they challenge a decision, they may lose their care. Too many people do not seek help or feel ignored, often when they are already vulnerable.”
The watchdog noted that there is poor collection and analysis of equality data, meaning councils are missing information which could help them understand how well they meet the social care needs of different groups, so services can be improved.
The EHRC said many local authorities agreed that they need to improve their collection and analysis of data about those who do and do not challenge adult social care decisions.
The commission also said legal support can help with complaints but the system is failing those who need it, as access to such support can be increasingly difficult because if people do not qualify for legal aid “the cost of initiating a judicial review is often prohibitive”.
The watchdog considered responses from 153 local authorities – 133 in England and 20 in Wales – in-depth interviews with 12 councils, 332 adult social care users, their representatives and carers, and interviews and focus group discussions with social care professionals, advocacy providers and older and disabled people’s organisations.
While local authorities are facing huge pressures, they must protect people’s rights when making decisions about their care— Marcial Boo, EHRC chief executive
It made a series of recommendations including a call for the Government to make the Local Government and Social Care Ombudsman (LGSCO) the statutory complaints standards authority for adult social care in England, and for it to get new powers to initiate investigations into areas of concern without the need for individual complaints.
It also said the Government should bring advocacy for adult social care complaints in England in line with the existing statutory entitlement for the health sector and that the Welsh Government should ensure a similar entitlement through the Citizen Voice Body for Health and Social Care.
EHRC chief executive Marcial Boo said the social care system in England and Wales is “struggling, with people’s needs being balanced against tight budgets”.
He added: “While local authorities are facing huge pressures, they must protect people’s rights when making decisions about their care. Effective ways for people to challenge those decisions are crucial to ensuring that good decisions are made and people’s needs are met.”
He said people “should not be left in the dark about how to challenge decisions that affect their wellbeing, dignity and independence so fundamentally”.
He added: “Our findings demonstrate that improvements must be made to the accessibility of information, the clarity of the complaints process and the availability of support.
“The need for reform and additional funding for local authorities to deliver social care is widely acknowledged. Our inquiry sets out a number of steps that should be taken now to uphold equality and human rights standards when people challenge decisions about their care.”
Louise Ansari, national director at Healthwatch England, said the inquiry report had highlighted that people’s rights are not being met, and that barriers for the public include inaccessible information, a lack of advocacy support, and confusion about where and how to give feedback about their experiences.
She added its recommendations must be supported, funded and implemented “so we can address care inequalities and move towards a future system that is built on personalisation, understanding, and respect”.
